Provider Information for 1770841702
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Dr. WILLIAM A PHILADELPHIA Ph.D.
Sex: Male
NPI: 1770841702
Last Updated: 2013-01-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1770841702 | ||||||||||||
| Enumeration Date | 2012-04-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 4625 LAUREN WOODS CT WINSTON SALEM, NC 27127-8919 United States Phone: 336-413-4807 | Fax: | ||||||||||||
| Primary Practice Address | 4625 LAUREN WOODS CT WINSTON SALEM, NC 27127-8919 United States Phone: 336-413-4807 | Fax: | ||||||||||||
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